HPV causes three types of cancer in males: throat cancer, anal cancer, and penile cancer. Of these, throat cancer is by far the most common, accounting for roughly 13,600 HPV-caused cases per year in American men. Across all three cancer types, HPV is responsible for an estimated 16,800 male cancers annually in the United States.
Throat Cancer Is the Biggest Risk
Oropharyngeal cancer, which develops in the back of the throat, base of the tongue, or tonsils, is the most significant HPV-related cancer in men. About 18,776 men are diagnosed with oropharyngeal cancer each year in the U.S., and roughly 72% of those cases are caused by HPV. That works out to approximately 13,600 HPV-driven throat cancers in men annually, making it far more common than the other two types combined.
HPV-positive throat cancer has a notably better prognosis than throat cancers caused by smoking and heavy drinking. Patients with HPV-positive throat cancer have a five-year disease-free survival rate of 85 to 90%, compared to just 25 to 40% for HPV-negative cases. This difference is significant enough that oncologists now consider HPV status one of the most important factors in treatment planning.
Symptoms can include a persistent sore throat, earaches, hoarseness, swollen lymph nodes, pain when swallowing, and unexplained weight loss. Some people have no symptoms at all, and the cancer is discovered when a neck lump turns out to be a swollen lymph node.
Anal Cancer
Anal cancer is the second most common HPV-related cancer in men, with about 2,622 cases diagnosed annually. HPV is the cause in 89% of those cases, the highest percentage of any male cancer site. That translates to roughly 2,300 HPV-caused anal cancers per year in men.
Men who have sex with men (MSM) and men living with HIV face the highest risk. For men with HIV, guidelines recommend screening for anal precancer starting at age 35 for MSM and transgender women, and at age 45 for all other people with HIV. Screening typically involves an anal Pap test (similar in concept to a cervical Pap smear) and, if abnormalities are found, a closer examination called high-resolution anoscopy. For men without HIV who aren’t in a high-risk group, there is currently no standard screening recommendation for anal cancer.
Penile Cancer
Penile cancer is the least common of the three, with about 1,429 cases per year. HPV causes roughly 63% of them, or around 900 cases annually. While relatively rare, penile cancer can require significant surgery depending on how advanced it is at diagnosis. Visible changes to the skin of the penis, such as growths, sores that don’t heal, or changes in color or texture, are typical early signs.
How HPV Turns Cells Cancerous
Most HPV infections clear on their own within a year or two. Cancer develops only when a high-risk strain lingers for years and its DNA integrates into the host cell’s genetic material. Two viral proteins do the damage: one disables a protein called p53 that normally stops damaged cells from multiplying, while the other breaks down another protective protein (Rb) that keeps cells from dividing uncontrollably. With both of these brakes removed, infected cells begin multiplying without the normal safety checks, eventually accumulating enough genetic damage to become cancerous.
There are 12 high-risk HPV strains, but two of them, HPV 16 and HPV 18, are responsible for the majority of HPV-related cancers. HPV 16 is particularly dominant in oropharyngeal and anal cancers in men.
No Routine Screening for Most Men
Unlike cervical cancer screening for women, there is no FDA-cleared HPV test for men and no widely recommended screening program for HPV-related cancers in the general male population. No method currently exists to detect HPV-related precancer in the throat, which is where most male HPV cancers occur. That means most oropharyngeal cancers are caught only after symptoms appear or a lump is noticed.
Anal cancer screening is available but is recommended only for higher-risk groups, primarily men with HIV. The test involves collecting cells from the anal canal, similar to a cervical Pap smear, sometimes combined with HPV testing. If you fall into a higher-risk category, it’s worth asking about screening specifically.
Prevention: Vaccination and Other Measures
The HPV vaccine is the most effective way to prevent HPV-related cancers. It protects against the seven HPV strains that cause most HPV-related cancers plus the two strains responsible for most genital warts. Clinical trials have shown efficacy close to 100% for preventing persistent infection with the targeted HPV types when given before exposure to the virus.
The CDC recommends routine HPV vaccination at ages 11 or 12 (it can start as early as 9) and catch-up vaccination through age 26 for anyone who wasn’t adequately vaccinated earlier. Adults aged 27 to 45 can also receive the vaccine on a three-dose schedule after discussing it with a healthcare provider, though the benefit is smaller since most people in that age range have already been exposed to HPV.
Condoms reduce the risk of HPV transmission but don’t eliminate it entirely, since HPV can infect skin not covered by a condom. Male circumcision has also been shown to be protective against high-risk HPV infection. Neither approach is as effective as vaccination, but both contribute to lower overall risk.